Dickerson's Winter Games Experience 6th and 7th Grade Field Trip is full. The overflow trip registratio is now open. Payment for it will be collected with this registration.

First Name *

Last Name *

Sex *

Shoe Size *

Age *

Grade *

Sport/Activity *

Experience past 2 yrs *

Sibling or other Family Participant

Last Name

Sex

Shoe Size

Age

Grade

Sport/Activity

Experience past 2 years

Enter Quantity/Program Selections

Ski/Snowboard Skills and Safety Program ONLY...... $99

Snow Sport Field TripCLOSED

SSSS on Campus AND Field Trip CLOSED

FEB 9 OVERFLOW TRIP $119 to be paid here

Ski/Snowboard Skill and Safety Program Options/
ON CAMPUS LESSONS *

Current Total includes 3% Tax:

$0.00

Parent/Guardian INFO

Relationship to Participants: *

Self

Mother

Father

Guardian

OtherOther

First Name *

Last Name *

Additional Parent/Guardian Name

Address 1 *

Address 2

City *

State *

Zip *

Phone *

Alternate Phone *

Email Address *

I under that there is risk of injury to myself or my child/ren from the activities involved in these programs. Including the potential for permanent disability and death, and while particular rules, equipment, and personal discipline may reduce this risk, the risk of serious injury does exist; and,
1) FOR MYSELF, SPOUSE, AND CHILD, I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASES or others, and assume full responsibility for my child's participation; and,
2) I willingly agree to comply with the program's stated and customary terms and conditions for participation. If I observe any unusual significant concern in my child's readiness for participation and/or in the program itself, I will remove my child from the participation and bring such attention of the nearest official immediately; and,
3) I myself, my spouse, my child, and on behalf of my/our heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS the Southern School of Snow Sports LLC and the Host School, County School System in which the school exists, or Host Organization or property ; Its directors, officers, officials, agents, employees, volunteers, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the event ("Releasees"), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property incident to my child's involvement or participation in these programs, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law.
4) I, for myself, my spouse, my child, and on behalf of my/our heirs, assigns, personal representatives and next of kin, HEREBY INDEMNIFY AND HOLD HARMLESS all the above Releasees from any and all liabilities incident to my involvement or participation in these programs, EVEN IF ARISING FROM THEIR NEGLIGENCE, to the fullest extent permitted by law.
I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, and by completing the registration AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT. *

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Contribution to The Prevent Offensive Inc a non-profit Drug and Alcohol Educational Foundation that supports PREvent DEfense Student Addiction Prevention Programs(TAX DEDUCTABLE) in Cobb County Schools including Walton, Lassiter and Pope High www.preventdefense.org

Current Total Includes 3% Tax

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